Real-life effectiveness of sofosbuvir/velpatasvir/voxilaprevir in hepatitis C patients previously treated with sofosbuvir/velpatasvir or glecaprevir/pibrentasvir
Por:
Ruiz-Cobo, JC, Llaneras, J, Forns, X, Moya, AG, Amiel, IC, Arencibia, A, Diago, M, Garcia-Samaniego, J, Castellote, J, Llerena, S, Rodriguez-Seguel, E, Mateos, B, Rodriguez, M, Zabal, JMR, Fernandez, I, Calleja, JL, Morillas, RM, Montoliu, S, Andrade, RJ, Aranda, EB, Hernandez-Guerra, M, Mate, CJ, Gonzalez-Santiago, JM, de Cuenca, B, Bernal-Monterde, V, Delgado, M, Turnes, J, Lens, S, Buti, M
Publicada:
1 jul 2024
Ahead of Print:
1 may 2024
Resumen:
BackgroundSofosbuvir, velpatasvir and voxilaprevir (SOF/VEL/VOX) is the recommended rescue therapy for patients with chronic hepatitis C infection who fail direct-acting antivirals (DAAs). Data are limited on the effectiveness of this treatment after the current first-line therapies. Our aim was to analyse the effectiveness and safety of SOF/VEL/VOX among patients failing sofosbuvir/velpatasvir (SOF/VEL) or glecaprevir/pibrentasvir (GLE/PIB).MethodsRetrospective multicentre study (26 Spanish hospitals), including chronic hepatitis C patients unsuccessfully treated with SOF/VEL or GLE/PIB, and retreated with SOF/VEL/VOX +/- ribavirin for 12 weeks between December 2017 and December 2022.ResultsIn total, 142 patients included: 100 (70.4%) had failed SOF/VEL and 42 (29.6%) GLE/PIB. Patients were mainly men (84.5%), White (93.9%), with hepatitis C virus genotype (GT) 3 (49.6%) and 47.2% had liver cirrhosis. Sustained virological response (SVR) was evaluated in 132 patients who completed SOF/VEL/VOX and were followed 12 weeks after end of treatment; 117 (88.6%) achieved SVR. There were no significant differences in SVR rates according to initial DAA treatment (SOF/VEL 87.9% vs. GLE/PIB 90.2%, p = 0.8), cirrhosis (no cirrhosis 90% vs. cirrhosis 87.1%, p = 0.6) or GT3 infection (non-GT3 91.9% vs. GT3 85.5%, p = 0.3). However, when considering the concurrent presence of SOF/VEL treatment, cirrhosis and GT3 infection, SVR rates dropped to 82.8%. Ribavirin was added in 8 (6%) patients, all achieved SVR.ConclusionSOF/VEL/VOX is an effective rescue therapy for failures to SOF/VEL or GLE/PIB, with an SVR of 88.6%. Factors previously linked to lower SVR rates, such as GT3 infection, cirrhosis and first-line therapy with SOF/VEL were not associated with lower SVRs.
Sofosbuvir, velpatasvir and voxilaprevir (SOF/VEL/VOX) is an effective rescue therapy for patients with chronic hepatitis C infection who have failed SOF/VEL and glecaprevir/pibrentasvir (GLE/PIB), achieving sustained virological response (SVR) in 89% of patients who completed treatment. There is a non-significant trend towards lower SVR rates in patients with GT3 HCV infection, cirrhosis and prior therapy with SOF/VEL.image
Filiaciones:
Ruiz-Cobo, JC:
Hosp Univ Vall Hebron, Liver Unit, Barcelona, Spain
Univ Autonoma Barcelona UAB, Barcelona, Spain
Llaneras, J:
Hosp Univ Vall Hebron, Liver Unit, Barcelona, Spain
Univ Autonoma Barcelona UAB, Barcelona, Spain
Forns, X:
Hosp Clin Barcelona, Liver Unit, Barcelona, Spain
Inst Invest Biomed August Pi & Sunyer FRCB IDIBAPS, Fdn Recerca Clin Barcelona, Barcelona, Spain
Univ Barcelona UB, Barcelona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Moya, AG:
Hosp Santa Creu & Sant Pau, Serv Patol Digest, Barcelona, Spain
Amiel, IC:
Hosp Univ & Politecn La Fe, Hepatol & Liver Transplantat Unit, Valencia, Spain
Inst Invest Sanitaria La Fe, IIS La Fe, Valencia, Spain
Arencibia, A:
Hosp Univ Nuestra Senora Candelaria, Dept Gastroenterol, Santa Cruz De Tenerife, Spain
Diago, M:
Hosp Gen Univ Valencia, Valencia, Spain
Univ Valencia, Dept Med, Valencia, Spain
Garcia-Samaniego, J:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ La Paz, Liver Unit, Madrid, Spain
Inst Invest Hosp Univ La Paz IDIPAZ, Madrid, Spain
Univ Autonoma Madrid, Madrid, Spain
Castellote, J:
Univ Barcelona UB, Barcelona, Spain
Hosp Univ Bellvitge, Gastroenterol Dept, Hepatol Unit, Barcelona, Spain
Univ Barcelona, Inst Invest Biomed Bellvitge IDIBELL, Barcelona, Spain
Llerena, S:
Hosp Univ Marques de Valdecilla, Gastroenterol & Hepatol Dept, Santander, Spain
Inst Invest Sanitaria Valdecilla IDIVAL, Santander, Spain
Rodriguez-Seguel, E:
Univ Seville, CSIC, Hosp Univ Virgen Rocio, Inst Biomed Sevilla IBIS,Liver Dis, Seville, Spain
Hosp Univ Virgen Rocio, Seville, Spain
Virgen Del Rocio Univ Hosp, Digest Dis Res Unit, Seville, Spain
Univ Seville, Fac Biol, Dept Cell Biol, Seville, Spain
Mateos, B:
Hosp Univ Ramon & Cajal, Dept Gastroenterol, Madrid, Spain
Inst Ramon & Cajal Invest Sanitaria IRYCIS, Madrid, Spain
Univ Alcala, Madrid, Spain
Rodriguez, M:
Hosp Univ Cent Asturias, Liver Unit, Div Gastroenterol & Hepatol, Oviedo, Spain
Univ Oviedo, Oviedo, Spain
Zabal, JMR:
Hosp Univ Costa Sol, Gastroenterol Dept, Marbella, Spain
Fernandez, I:
Hosp Univ 12 Octubre, Gastroenterol Dept, Madrid, Spain
Calleja, JL:
Univ Autonoma Madrid, Madrid, Spain
Hosp Univ Puerta Hierro, Serv Gastroenterol & Hepatol, Madrid, Spain
Inst Invest Sanitaria Puerta Hierro IDIPHIM, Madrid, Spain
Morillas, RM:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Badalona Germans Trias & Pujol, Hepatol Unit, Badalona, Spain
Inst Hlth Sci Res Germans Trias & Pujol IGTP, Badalona, Spain
Barcelona Autonomous Univ UAB, Dept Med, Barcelona, Spain
Montoliu, S:
Univ Joan XXIII, Gastroenterol Dept Hosp, Tarragona, Spain
Inst Invest Sanitaria Pere Virgili IISPV, Tarragona, Spain
Andrade, RJ:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ Virgen Victoria, Malaga, Spain
Univ Hosp IBIMA Platform BIONAND, Malaga, Spain
Univ Malaga, Malaga, Spain
Aranda, EB:
Hosp Univ Burgos, Gastroenterol Dept, Burgos, Spain
Hernandez-Guerra, M:
Hosp Univ Canarias, Santa Cruz De Tenerife, Spain
Mate, CJ:
Hosp Univ Virgen Valme, Gastroenterol Dept, Seville, Spain
Gonzalez-Santiago, JM:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Univ Hosp Salamanca, Dept Gastroenterol & Hepatol, Salamanca, Spain
Inst Invest Biomed Salamanca IBSAL, Salamanca, Spain
de Cuenca, B:
Hosp Univ Getafe, Getafe, Spain
Bernal-Monterde, V:
Hosp Univ Miguel Servet, Serv Aparato Digest, Zaragoza, Spain
Inst Invest Sanitaria Aragon IISA, Zaragoza, Spain
Delgado, M:
Hosp Univ La Coruna, La Coruna, Spain
Turnes, J:
Complejo Hosp Univ Pontevedra & IIS Galicia Sur, Dept Gastroenterol & Hepatol, Pontevedra, Spain
Lens, S:
Hosp Clin Barcelona, Liver Unit, Barcelona, Spain
Inst Invest Biomed August Pi & Sunyer FRCB IDIBAPS, Fdn Recerca Clin Barcelona, Barcelona, Spain
Univ Barcelona UB, Barcelona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Buti, M:
Hosp Univ Vall Hebron, Liver Unit, Barcelona, Spain
Univ Autonoma Barcelona UAB, Barcelona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ Vall dHebron, Liver Unit, Dept Internal Med, Passeig Vall dHebron 119-129, Barcelona, Spain
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